Adult Issues We Commonly Treat

Abuse

There are many forms of abuse, including verbal, physical, emotional and sexual abuse. What each of these forms of abuse have in common is that they all cause significant psychological harm to the victim. Verbal abuse, which often takes the form of angry outbursts, attacks the nature, character and/or abilities of an individual. Such abuse can feel threatening, intimidating and humiliating. Physical abuse includes the use of aggressive behavior toward another, and may include hitting, pushing, kicking, shoving, biting, burning, punching etc. Emotional abuse is usually not a single event but tends to occur over time. It includes a pattern of behavior that intimidates, devalues, frightens, or invalidates the individual to whom it is directed. Sexual abuse, most commonly experienced in childhood and adolescence, represents an attack on the victim’s body, mind, personality, sense of safety, trust, sense of order etc.

The impact of such victimization can, and often does, lead to significant symptoms of psychological distress. These might take the form of relational difficulties, anxiety, panic, depression, low self-esteem, self-harm, social withdrawal and alterations in consciousness. Psychotherapy with a therapist experienced in the nature of abuse and trauma can lead to healing and recovery.

Anxiety

Anxiety is a normal response to the challenges of our daily lives. It has adaptive qualities, signaling a heightened awareness that can be helpful in stressful situations. Anxiety disorders, however, can fill a person’s life with feelings of fear, apprehension, hyper-vigilance, excessive worry, panic, and/or obsessions that interfere with a person’s daily life.

Anxiety disorders are considered the most common mental illness in the United States, affecting close to 20 million adults. There are several major categories of anxiety disorders, including generalized anxiety disorder, obsessive-compulsive disorder (OCD), post traumatic stress disorder (PTSD), panic disorder, phobias and social anxiety disorder.Anxiety disorders often co-exist with other disorders, including depression, eating disorders and other conditions. If you or a family member suffers with the symptoms of an anxiety disorder, it may be time to seek help. Psychotherapy, and in some cases medication, can be effective in treating each of these anxiety disorders.

Bipolar Disorder

Less common than depression or anxiety, bipolar disorder is diagnosed in about 1% of the adult population, although it can also affect children and teens. It is a disorder characterized by drastic mood swings that can last hours, days or months. There are two main types of bipolar disorder. Bipolar 1 is the more severe type. Here, during a manic episode, behavior can become impulsive, wild and erratic, risky and uncontrolled. In its extreme, manic episodes can mimic psychosis. Depressive episodes can occur suddenly and be quite severe. Hospitalization may be required during severe manic or depressive episodes. Bipolar II is more common. Here, ‘up’ periods are characterized by rapid thoughts and increased energy and do not have the more dramatic behaviors associated with bipolar 1. People suffering with bipolar II disorder usually seek treatment during a depressive phase.

Obtaining an accurate diagnosis is the first critical step. Treatment is available. It almost always includes medication management. When combined with psychotherapy, an individual with bipolar disorder can lead a normal and productive life.

Depression

Depression is a serious and painful illness that can affect our body, our emotions, our thoughts, our relationships and our capacity to participate fully in life. It is normal to sometimes experience sadness, or the blues. That is not depression. It is not something that can be snapped out of. An individual suffering with depression often feels discouraged, sometimes defeated, loses interest in activities once enjoyed, may experience sleep disturbances or changes in appetite, decreased energy and fatigue, increased irritability and worry and can withdraw from the activities of daily living. In extreme cases, the depressed individual can be suicidal.

Depressive disorders come in different forms. Major depression is characterized by a combination of the symptoms described above, while dysthymia is a less severe form of depression that is less debilitating than major depression and tends to be a more chronic condition. Symptoms of a depressive disorder can last for months or years. Appropriate treatment, which includes psychotherapy and may include medication, can help most who suffer from depression.

Eating Disorders

Eating disorders involve serious disturbances in eating behaviors. Over the past few decades, eating disorders, including anorexia, or anorexia nervosa, bulimia and compulsive binge eating, have risen to very troublesome levels in the United States. Although primarily affecting women, the occurrence of eating disorders in males is rising. Individuals suffering with an eating disorder feel that they have little or no control over their symptoms, which may include a preoccupation with food, severe calorie restriction, a categorization of food as ‘good’ or ‘bad’, body image issues, compulsive binging on large quantities of high calorie food, self-induced vomiting, excessive use of laxatives etc. Common to all individuals suffering from an eating disorder is secrecy, shame, guilt and self-blame.

An eating disorder is both very serious and very complex, affecting one’s emotional, behavioral and physical self. There are a wide range of physical health complications associated with eating disorders, including heart problems, kidney problems, rotting teeth, hair loss and, in some cases, death. Individuals suffering with an eating disorder can be treated successfully. Treatment for these complex disorders may require a team approach, including psychotherapists specially trained in working with individuals and families experiencing this disorder, nutritionists and medical personnel.

Grief & Loss

Grief and loss are an inevitable part of the human experience and our responses to our loss can vary. They may occur soon after the loss or can be delayed for a long period of time. Our responses may include feelings of sadness, upset, worry, fear, anger, confusion, guilt or denial. Sometimes we feel numb. Sometimes we become clinically depressed. Psychotherapy that addresses the issues and feelings related to our grief and loss can be extremely helpful in successfully getting through this time and healing.

Life Transitions

Life brings with it periods of change, whether it’s the ending of a relationship, a marriage, a divorce, the birth of a child, entering the working world, changing a job or profession, retirement, aging, illness or death. Sometimes an event or situation throws you off balance, producing all sorts of feelings, including anxiety or depression. When confronted with physical, emotional or social changes that seem difficult to manage, psychotherapy can help. In some cases therapy can be brief, focusing on working through the difficulties associated with that particular life situation. Other times psychotherapy uncovers a pattern of responding that isn’t helpful. When these dynamics are revealed, then healing and choices become possible.

Pain and Physical Conditions

Pain, especially chronic pain, is both complex and disruptive. There can be psychological factors underlying pain, and pain itself can generate emotional distress. For a subset of individuals with chronic pain, those with fibromyalgia as an example, research tells us that they tend to experience significant anxiety and depression. Anxiety and depression can make chronic pain worse. Treating these mental health issues can have an impact on a person’s chronic pain.

We now know that there is a significant interrelationship between psychological well-being and physical health. Psychological factors impact our physical health and physical illness can be a profound stressor with significant psychological impact. Individuals with health problems or those being treated for a injury may develop symptoms including mood swings, anxiety, phobias, depression, anger, prolonged unexplained pain and post traumatic stress disorder (PTSD). And research tells us that psychological distress can significantly contribute to medical conditions, including headaches, asthma, heart disease and cancer. Psychotherapy can help to alleviate the psychological issues that may be underlying, or contributing to, pain and physical illness. Psychotherapy can also help the person experiencing a physical illness with the resulting emotional distress that can be so impactful.

Relationship Issues

We human beings are relational animals. Our lives are lived in relationship with others, through our work, our family and our friends. For many of us, problems in our relationships can be among the most frustrating issues we face. In some schools of thought, it is our earliest relationships that color the way we relate to and experience others. Those early disappointments that set the stage for our fear of intimacy, as an example. Through psychotherapy, insight into these relational patterns can lead to the healing of old wounds and the opportunity to ‘get it right’.

When couples are having difficulties in their relationship, coming together for couples or marriage counseling can help. Relationships can be strengthened through help with communication skills, understanding the needs of each partner, resolving conflict and resentments, learning how to have constructive disagreements, problem resolution skills, negotiation skills, and developing a path toward improved intimacy.

While many couples come to relationship counseling with a goal of strengthening their relationship, other couples seek out relationship counseling because they want to break up. We don’t assume that all couples should stay together. Sometimes ending a relationship is healthier than staying together. Counseling, here, can help the separation process be more amicable.

Stress

Everyone has had the experience of feeling stress. Called the ‘fight or flight’ response, it was and is a crucial survival technique for humans. This response is healthy and life preserving when genuine danger is present. In our modern life, however, where danger itself is less likely to be a physical threat, it can be counterproductive. When dealing with any of the multitude of pressures we may encounter in our daily life, our stress response can easily be triggered with no useful outcome. Our response to stress can become a major problem when it begins to impact our body, our emotions or our behavior. Excessive stress can lead to psychological effects including anxiety, depression, anger and rage, guilt, emotional volatility and cognitive deficits. Physiologically, it can lead to fatigue, muscle aches, stomach problems, weight gain or loss, insomnia and low sex drive or erectile dysfunction. Psychotherapy can help with stress reduction, stress resiliency, stress management and help you learn to balance the various aspects of your life.

Trauma and PTSD

Trauma are those painful life events outside the range of normal experience. Trauma can be a one-time experience, such as a mugging, rape or being a 9/11 survivor, or it may have been ongoing, such as emotional, physical or sexual abuse in childhood, or domestic violence. Trauma can deeply affect the way you experience yourself, your relationships and your world. Reactions to trauma can be immediate, or they can manifest over time, sometimes taking years to emerge. An individual who has experienced trauma may suffer from a loss of sense of trust, low self esteem, anxiety, panic attacks, depression, intrusive memories, nightmares, hypervigilance, withdrawal or emotional numbing. Psychotherapy with a therapist who understands trauma and trauma reactions, including post traumatic stress disorder, or PTSD, is critically important for healing and moving forward with one’s life.

Other common issues that arise during adulthood

Families deal with many different issues that can impact the emotional health of each individual as well as the whole family system. When families face difficulties, conflicts or challenges, destructive relational patterns can develop. Family therapy can provide each family member an opportunity to address these challenges and stresses. Family members can learn to support and respect one another, and new patterns of interactions can be developed and solutions to family issues can be found.

Gay and Lesbian Issues – Most of our gay and lesbian patients seek out psychological counseling for the same reasons as our heterosexual patients: difficulties with relationships, depression, anxiety etc. There are, however, some concerns that are unique. These include issues relating to ‘coming out’, uncertainty about or acceptance of sexual orientation, gay and lesbian relationships, etc. Our mental health therapists are specially trained and can help in each of these areas.

Geriatric Issues – As we age, we are confronted with emotional, physical and social changes that can be difficult. Dealing with medical illness, grief and loss, anxiety, chronic pain, depression, feelings of isolation and loss of independence that can come with aging can be very challenging. Our specially trained therapists understand the importance of psychoeducation, psychosocial intervention, and combining psychotherapy and medication can be the preferred treatment.

Personal Issues that can be impactful during adulthood include difficulty with adjustment to new situations, low self-esteem, chronic or excessive worry, irritability, sadness, anger issues, jealosy, loneliness, guilt and sexual difficulties. Our therapists are very experienced in working with individuals experiencing such issues, and psychotherapy can be very effective in helping people overcome these difficulties.

Substance Use or Abuse is often a signal that an individual is in a great deal of emotional pain. It is critical to treatment that the issues underlying substance use and abuse be addressed. Addressing that which has led to the use or abuse of alcohol or drugs needs to be understood and therapeutically worked through so that he or she can learn to cope in more healthy ways to life’s stresses. We provide drug and alcohol education while addressing the underlying problems. If an intensive program is considered a necessary initial step, we can provide those recommendations.

Other issues that arise during adulthood that we commonly treat include mood disorders, workplace issues, career issues, infertility issues, post partum depression, and role issues for women and men.